As I mentioned, since reading "Natural birth the bradley way", I've also read a couple of other books on the topic of delivery, and more specifically, the things that your doctors don't necessarily tell you ("The thinking woman's guide to a better birth", and "The silent knife" about C-sections and VBAC. I wouldn't say that reading these has scared me, but they have definitely raised some questions in my mind about standard obstetrical practice that have made me realize that M and I are going to need to be more proactive in our management of Phred's delivery that I would have anticipated had I not read these books, and learned about the possible negative effects of standard care. So, here's what I'm thinking (assuming, of course, that I don't have to have a c-section because Phred is still breech).
Please note that these are my opinions, based on what I've read. I'm not criticizing anyone else's choices!
1. Eating and drinking during active labor. Strongly discouraged by the hospital, in case you need general anesthesia for an emergency c-section. Problem is that it can cause dehydration (leading to the need for IV fluids, see #2), and lack of energy for the second stage of labor. Which can lead to an extended pushing phase, and c-section for "failure to progress". They claim that if you are put under with food in your stomach, you might throw up and aspirate the contents of your stomach = bad. But, if you haven't been eating or drinking, you throw up gastric juices, which to me seems a lot worse. At my hospital, the rate of c-sections is 30%, the rate of general anesthesia is 5%, which means that absolute max, 1.5% of people are having GA with a c-section. And as the 30% rate includes planned c-sections as well, it's actually a lot less than that. AND, if someone's been in a car accident or the like, they almost certainly don't have an empty stomach. So I think that the prohibition on eating / drinking is bogus, and don't plan to follow it. (Which I will let them know if I do end up needing GA).
2. No IV fluids for hydration. The rate of IV's is quite astonishing - 94%! Are that many of us really dehydrated? When I was in for my contractions they stuck an IV in me 2/3 times - the first I managed to convince them that I really was not having the contractions because of dehydration (I had had over 100oz of fluid during the day). The second time they wanted to try it anyway, despite my saying the same thing. And it made no difference to the contractions whatsoever. And then the third was when I was having the magnesium, which needed to go in through an IV. But, our hormones are fairly delicately balanced, and getting more fluid than needed can screw with that balance. Perhaps leading to a slowdown in labor, so pitocin to help... blah blah blah. Slippery slope.
3. No induction. If Phred isn't ready to come out yet, I don't see any reason to force it. Plus, it seems like very few people who are induced end up with a normal, natural labor. I'd rather be pregnant for a few more days.
4. No breaking of waters to speed up labor. The amniotic sac can A) help with opennig the cervix more gently, B) cushion the baby's head, and C) equalize the pressure the baby feels with contractions - less fetal distress.
5. Minimal external fetal monitoring. The standard is to throw those suckers on you as soon as you arrive in the hospital, and keep them on the entire time. However, they definitely seem to lead to a higher c-section rate, because as soon as any kind of issue is seen, the doctors feel like they have to fix it right away. There has been a fair amount of research into this topic, and almost every article says that "intermittent auscultation" is just as effective at catching real problems as the continuous monitoring is, while lessening the c-section rate.
6. No time limits on labor (within reason). First, there seems to be a "you have to deliver within 24 hours of your water breaking" paradigm in place these days. Because of threat of infection. But studies have shown that there is no increased risk of infection just because of broken waters, especially if no internal exams are performed. So I'm thinking that if this happens and I don't start having contractions right away, I'm not even going to bother calling the hospital at that point. I also do not want a c-section just because I've been in phase 1 for X number of hours, or phase 2 for 2 hours. The time limits used seem to be actually quite fast, so I'm not going to let them pressure me into having a c-section just because of those.
7. No scheduled c-section, even if Phred does seem to want to stay breech. I figure the longer he/she is in there, the more chance there is of turning over, however remote it may be.
I think that about covers it!